Impact of corticosteroid administration on contrast-enhancing volume and diffusion MRI in treatment naïve glioblastoma.

IF 16.4 1区医学 Q1 CLINICAL NEUROLOGY

Neuro-oncology Pub Date : 2025-05-30 DOI:10.1093/neuonc/noaf136

Francesco Sanvito, Asher Kim, Catalina Raymond, Ashley Teraishi, Richard G Everson, Phioanh L Nghiemphu, Albert Lai, Robert A Chong, David A Nathanson, Noriko Salamon, Timothy F Cloughesy, Jingwen Yao, Benjamin M Ellingson

{"title":"Impact of corticosteroid administration on contrast-enhancing volume and diffusion MRI in treatment naïve glioblastoma.","authors":"Francesco Sanvito, Asher Kim, Catalina Raymond, Ashley Teraishi, Richard G Everson, Phioanh L Nghiemphu, Albert Lai, Robert A Chong, David A Nathanson, Noriko Salamon, Timothy F Cloughesy, Jingwen Yao, Benjamin M Ellingson","doi":"10.1093/neuonc/noaf136","DOIUrl":null,"url":null,"abstract":"Background: Corticosteroids impact the radiographic interpretation of glioblastoma, including artificial reduction in contrast-enhancing tumor volume and intensity (i.e., a \"pseudoresponse\") and in the apparent coefficient diffusion (ADC). This study aimed to estimate the influence of corticosteroids on these measurements in treatment naïve glioblastoma before surgery.Methods: 57 pairs of MRI scans from 54 patients with pre-surgical treatment-naïve glioblastoma were retrospectively grouped as increased (n=29, all corticosteroid-free at baseline), stable (n=25), or decreased (n=3) corticosteroid dose between scans (median interval: 15 days). Tumor size and ADC changes between timepoints were compared between lesions with increased and stable corticosteroids. Volumetric changes ascribable to increased corticosteroid dose was modeled, adjusting for the time between scans.Results: Increased corticosteroid dose showed an observed volumetric shrinkage of the contrast-enhancing tumor (median: -23.7%) and reduction in estimated growth rates (median: -2.48% per day), significantly different (p<0.0001) from the control group receiving a stable dose (median: +36.0% volume; +2.08% growth rate). When adjusting for the time interval between scans, the estimated corticosteroid-induced volumetric shrinkage was 44.0% (p<0.0001, 95%C.I. 25.7-62.2%). Increased corticosteroid dose also decreased ADC in the contrast-enhancing tumor (median: 180, IQR=39-281×10-6 mm2/s, p=0.0005).Conclusion: Corticosteroid administration can induce a significant \"pseudoresponse\" in glioblastoma, with an observed reduction in contrast-enhancing tumor volume of 23.7% and a time interval adjusted reduction of 44.0% (25.7-62.2%), and an ADC drop of 180×10-6 mm2/s (14.2%). These data confirm that radiographic measurements are impacted by corticosteroids and provide benchmarks for development of adjusted response criteria accounting for corticosteroid use.","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":16.4000,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuro-oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/neuonc/noaf136","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Corticosteroids impact the radiographic interpretation of glioblastoma, including artificial reduction in contrast-enhancing tumor volume and intensity (i.e., a "pseudoresponse") and in the apparent coefficient diffusion (ADC). This study aimed to estimate the influence of corticosteroids on these measurements in treatment naïve glioblastoma before surgery.

Methods: 57 pairs of MRI scans from 54 patients with pre-surgical treatment-naïve glioblastoma were retrospectively grouped as increased (n=29, all corticosteroid-free at baseline), stable (n=25), or decreased (n=3) corticosteroid dose between scans (median interval: 15 days). Tumor size and ADC changes between timepoints were compared between lesions with increased and stable corticosteroids. Volumetric changes ascribable to increased corticosteroid dose was modeled, adjusting for the time between scans.

Results: Increased corticosteroid dose showed an observed volumetric shrinkage of the contrast-enhancing tumor (median: -23.7%) and reduction in estimated growth rates (median: -2.48% per day), significantly different (p<0.0001) from the control group receiving a stable dose (median: +36.0% volume; +2.08% growth rate). When adjusting for the time interval between scans, the estimated corticosteroid-induced volumetric shrinkage was 44.0% (p<0.0001, 95%C.I. 25.7-62.2%). Increased corticosteroid dose also decreased ADC in the contrast-enhancing tumor (median: 180, IQR=39-281×10-6 mm2/s, p=0.0005).

Conclusion: Corticosteroid administration can induce a significant "pseudoresponse" in glioblastoma, with an observed reduction in contrast-enhancing tumor volume of 23.7% and a time interval adjusted reduction of 44.0% (25.7-62.2%), and an ADC drop of 180×10-6 mm2/s (14.2%). These data confirm that radiographic measurements are impacted by corticosteroids and provide benchmarks for development of adjusted response criteria accounting for corticosteroid use.

查看原文本刊更多论文

皮质类固醇给药对治疗naïve胶质母细胞瘤的对比增强体积和扩散MRI的影响。

背景：皮质类固醇会影响胶质母细胞瘤的影像学解释，包括人为降低对比增强肿瘤的体积和强度（即“假反应”）和表观扩散系数（ADC）。本研究旨在评估手术前治疗naïve胶质母细胞瘤时皮质类固醇对这些测量的影响。方法：54例术前treatment-naïve胶质母细胞瘤患者的57对MRI扫描回顾性分组为扫描间皮质类固醇剂量增加（n=29，基线时无皮质类固醇）、稳定（n=25）或减少（n=3）（中位数间隔：15天）。肿瘤大小和ADC在不同时间点之间的变化在皮质类固醇增加和稳定的病变之间进行比较。体积变化归因于增加皮质类固醇剂量建模，调整扫描之间的时间间隔。结果：皮质类固醇剂量的增加显示对比增强肿瘤的体积缩小（中位数：-23.7%）和估计生长速率的降低（中位数：-2.48% /天），差异有统计学意义(p)结论：皮质类固醇给药可诱导胶质母细胞瘤的显著“假反应”，对比增强肿瘤体积减少23.7%，时间间隔调整减少44.0% (25.7-62.2%)，ADC下降180×10-6 mm2/s（14.2%）。这些数据证实了放射测量受到皮质类固醇的影响，并为制定考虑皮质类固醇使用的调整反应标准提供了基准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Neuro-oncology 医学-临床神经学

CiteScore

27.20

自引率

6.30%

发文量

1434

审稿时长

3-8 weeks

期刊介绍： Neuro-Oncology, the official journal of the Society for Neuro-Oncology, has been published monthly since January 2010. Affiliated with the Japan Society for Neuro-Oncology and the European Association of Neuro-Oncology, it is a global leader in the field. The journal is committed to swiftly disseminating high-quality information across all areas of neuro-oncology. It features peer-reviewed articles, reviews, symposia on various topics, abstracts from annual meetings, and updates from neuro-oncology societies worldwide.